Distal Aortic Perfusion and Cerebrospinal Fluid Drainage for Thoracoabdominal Aortic Repair

Objective: The purpose of this study was to evaluate the short-term results of thoracoabdominal repair using distal aortic perfusion and cerebrospinal fluid (CSF) drainage. Methods: Between January 2000 and May 2007, we performed 38 thoracoabdominal aortic repairs. Twenty-five ( 66%) were male, and the mean age of all patients was 66 years, (range, 31 to 82 years). The patients distribution of thoracoabdominal aortic aneurysm, according to Safi's classification, was 8 extent 1, 9 extent 11, 7 extent III, 8 extent IV, and 6 extent V. Four patients, who presented with rupture underwent emergency repair. Distal aortic perfusion was used in 38 (100%) and CSF drainage in 14 (37%) of 38 patients. Twenty-nine (76%) of 38 patients inderwent intercostal artery reattachment. Results: The hospital mortality was 16% (6 of 38 patinets), 9% (3 of 4 emergency repairs) and 9%( three of 34 non-emergency repairs). Immediate neurologic deficit was 2 (6%) of 38 patients, 1(25%) of 4 emergency repairs without CSF drainage, and 1(2.9%) of 34 non-emergency repairs. Conclusions: The short-term results of thoracoabdominal repair using distal aortic perfusion, CSF drainage and aggressive intercostal aretery reattachment might be acceptable. But neurologic deficit following repairs of TAAA remains a devastating complication.